The major finding of the study and the use of omega-3 fatty acids are already in the mainstream of research on depression and heart disease, said Dr. Alexander H. Glassman, a professor of psychiatry at Columbia University Medical Center in New York City.
"There is a torrent of information that depression in relation to vascular disease worsens the outcome," Glassman said. "If you look at post-stroke patients, you find the same data. If you look at heart failure, depression has a similar effect on mortality."
The value of the study is that it had the longest follow-up of any trial using diagnostic interviews, which are regarded as more accurate than self-reporting, Glassman said. "It makes the evidence firmer and extends the evidence," he explained.
The use of omega-3 fatty acids is "a hot issue," being tried in cardiac and non-cardiac cases, Glassman said. "It is a logical thing to do," he added.
The study and the omega-3 trial will still leave some major issues about depression and heart disease open, Glassman said.
"The two key questions that remain are: Does treating depression make the outcome better? And what is it about depression that is causing the problem in the first place?" he said.
Advice on depression after a heart attack is offered by the American Academy of Family Physicians.
SOURCES: Robert M. Carney, Ph.D., professor, psychiatry, Washington University School of Medicine in St. Louis; Alexander H. Glassman, M.D., professor, psychiatry, Columbia University Medcial Center, New York City; March 2008, Journal of Affective Disor
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